Abstract

AimThe aim of this systematic review was to identify the evidence contributed by qualitative research studies of foreign educated nurses’ work experiences in a new country and to link the results to patient safety competencies.DesignA systematic literature review of qualitative studies.MethodsElectronic searches in the Ovid MEDLINE, Embase, PsycINFO, Cochrane Library and Cinahl databases and additional manual searches in five scientific journals. A content analysis of 17 qualitative articles was conducted.ResultsThe analysis revealed one main theme: “Being an outsider at work” and two themes: “Cultural dissonance and Unfamiliar nursing practice. Two sub‐themes emerged from the first theme; Loneliness and discrimination” and “Communication barriers”. The second theme was based on the following two sub‐themes: “Handling work‐related stress” and “Role uncertainty and difficulties in decision‐making”. A better prepared and longer orientation period with continual clinical supervision including systematic reflection on practice experiences is needed to support foreign educated nurses in the transition period and strengthen their Patient Safety Competencies. Nurse Managers have an important role in ensuring the inclusion of foreign educated nurses and providing desirable working conditions.

Highlights

  • The migration of nurses due to nursing shortages has been considered a global concern (An, Cha, Moon, Ruggiero, & Jang, 2016)

  • The aim of this systematic review was to identify the evidence contributed by qualitative research studies of foreign educated nurses (FENs)’ work experiences in a new country and to link the results to patient safety competencies

  • The main theme Being an outsider at work and two themes; Cultural dissonance and Unfamiliar nursing practice that emerged from the analysis revealed that the experience of being an outsider at work makes FENs uncertain in their new practice environment, which has an impact on patient safety

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Summary

Introduction

The migration of nurses due to nursing shortages has been considered a global concern (An, Cha, Moon, Ruggiero, & Jang, 2016). In 2013, the International Council for Nurses Workforce Forum found that most industrialized countries were or would be facing a shortage of nurses due to increased demands for health care (Li, Nie, & Li, 2014). The World Health Organization (WHO) has proposed a Global Code of Practice on the International Recruitment of Health Personnel. The International Council of Nursing (ICN) Position Statement on Scope of Nursing Practice (ICN, 2013) states that employers have a responsibility to support nurses in practicing within their full scope of practice This includes not placing nurses in situations where they are asked to practice beyond their level of competence or outside their legal scope of practice and providing practice environments that support safe and competent care

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